CLARA Analytics, an AI-powered claims processing solutions provider, has introduced CLARA Fraud, for workers' compensation claims management.
CLARA Fraud leverages the company’s AI platform and large workers’ compensation datasets to identify fraudulent claims through supervised and unsupervised AI learning techniques.
It analyzes various factors, including servicing locations, claimants having multiple claims open at the same time, the same attorney working on similar claims, and exaggerated claims. It also has a unique feature of examining the behavior and relationships between medical providers, legal counsel, and claimants across millions of workers’ compensation claims.
In addition, the product assists adjusters in justifying referrals to investigation units.
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